背景:管理2型糖尿病(T2D)和肥胖的策略随着靶向治疗的引入而不断发展,包括基于肠促胰岛素的双重激动剂和对多学科护理重要性的日益了解。可访问,需要开展有效的继续医学教育(CME)活动,以确保卫生保健专业人员(HCP)了解并能够实施最新数据,从而优化患者预后.
目的:我们旨在衡量知识的变化,能力,和自我报告的表现,并在参与基于网络的教育活动后使用匿名的患者数据定量评估表现的变化。由教师领导的CME认可的活动基于基于肠促胰岛素的双重激动剂和T2D和肥胖的患者教育。还查明了这一领域剩余的教育差距。
方法:CME认证,基于网络的,多学科(touchMDT)教育活动名为“T2D和肥胖症的血糖控制和体重减轻的未来:基于Incretin的双重激动剂和优化患者教育”。HCP知识,能力,和绩效在活动前后根据摩尔的扩展结果框架(1-5级)进行评估,使用自我报告问卷和分析匿名患者记录数据。
结果:为了评估知识和能力(活动前的50名受访者和活动后的50名学习者),活动后正确回答问题的平均数显著较高(中位数5.0,IQR4.0-6.0~6.0,IQR5.0-7.0;平均值4.98,SD1.22~5.78,SD1.13;P<.001).谦虚,从活动前后观察到自我报告的表现(N=50名受访者活动前;N=50名学习者活动后)无显著改善(中位数4.0,IQR3.25-4.0至4.0,IQR4.0-4.0;平均值3.64,SD0.69至3.76,SD0.48;P=.32).PPatient数据分析表明,患者在活动后接受更密集的治疗:活动前,最常用的治疗方案是二甲双胍单药治疗(13/50,26%)和二甲双胍联合可注射胰高血糖素样肽-1(GLP-1)受体激动剂(RA;11/50,22%);这更改为二甲双胍+可注射GLP-1RA的双重治疗(12/50,24%)和二甲双胍+可注射GLP-1RA+钠-葡萄糖协同转运蛋白2抑制剂的三联治疗(SGLT2i;10/50,20%).此外,转诊给专家组合的人数有所增加(医生转诊了27%,8/30的患者在活动前≥2名专家和36%,活动后10/28至≥2名专家)。剩下的教育差距包括了解肥胖的生物学和心理学,基于肠促胰岛素的双重激动剂的疗效和安全性数据,以及糖尿病教育者或糖尿病护理和教育专家在管理T2D和肥胖方面的作用。
结论:这个简短的,基于网络的CME活动对T2D和肥胖的管理导致HCP知识的改善,能力,和性能。确定了一些剩余的未满足需求,可用于告知该疾病领域未来教育活动的内容。
BACKGROUND: Strategies for managing type 2 diabetes (T2D) and obesity are evolving with the introduction of targeted therapies, including incretin-based dual agonists and growing knowledge of the importance of multidisciplinary care. Accessible, effective continuing medical education (CME) activities are required to ensure that health care professionals (HCPs) understand and can implement the most recent data to optimize patient outcomes.
OBJECTIVE: We aimed to measure changes in knowledge, competence, and self-reported performance and quantitatively evaluate changes in performance using anonymized patient data following participation in a web-based educational activity. The faculty-led CME-accredited activity was based on incretin-based dual agonists and patient education on T2D and obesity. The remaining educational gaps in this field were also identified.
METHODS: A CME-accredited, web-based, multidisciplinary (touchMDT) educational activity titled \"The future for glycemic control and weight loss in T2D and obesity: Incretin-based dual-agonists and optimizing patient education\" was developed. HCP knowledge, competence, and performance were assessed before and after the activity against Moore\'s expanded outcomes framework (levels 1-5), using self-reported questionnaires and by analyzing anonymized patient record data.
RESULTS: For evaluating knowledge and competence (50 respondents before and 50 learners after the activity), the mean number of correctly answered questions was significantly higher post activity (median 5.0, IQR 4.0-6.0 to 6.0, IQR 5.0-7.0; mean 4.98, SD 1.22 to 5.78, SD 1.13; P<.001). Modest, nonsignificant improvements in self-reported performance (N=50 respondents preactivity; N=50 learners postactivity) from before to after the activity were observed (median 4.0, IQR 3.25-4.0 to 4.0, IQR 4.0-4.0; mean 3.64, SD 0.69 to 3.76, SD 0.48; P=.32). PPatient data analysis indicated that patients were being treated more intensively postactivity: before the activity, the most commonly used treatment regimens were metformin monotherapy (13/50, 26%) and dual therapy with metformin plus injectable glucagon-like peptide-1 (GLP-1) receptor agonist (RA; 11/50, 22%); post activity, this changed to dual therapy with metformin plus injectable GLP-1 RA (12/50, 24%) and triple therapy with metformin plus injectable GLP-1 RA plus sodium-glucose cotransporter-2 inhibitor (SGLT2i; 10/50, 20%). In addition, there was an increased number of referrals to a combination of specialists (physicians referred 27%, 8/30 of patients to ≥2 specialists before the activity and 36%, 10/28 to ≥2 specialists post activity). The remaining educational gaps included understanding the biology and psychology of obesity, efficacy and safety data for incretin-based dual agonists, and the role of the diabetes educator or diabetes care and education specialist in managing T2D and obesity.
CONCLUSIONS: This short, web-based CME activity on the management of T2D and obesity led to improvements in HCP knowledge, competence, and performance. Several remaining unmet needs were identified, which can be used to inform the content of future educational activities in this disease area.